Healthcare Provider Details

I. General information

NPI: 1205832623
Provider Name (Legal Business Name): SHEILA MARIE SWARTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 POLER STREET
STARBUCK MN
56381-0460
US

IV. Provider business mailing address

PO BOX 460
STARBUCK MN
56381-0460
US

V. Phone/Fax

Practice location:
  • Phone: 320-239-3939
  • Fax: 320-239-2802
Mailing address:
  • Phone: 320-239-3939
  • Fax: 320-239-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1685233
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: